TY - JOUR
TI - Histopathological Outcomes after Irreversible Electroporation for Prostate Cancer: Results of an Ablate and Resect Study
AU - van den Bos, W.
AU - Jurhill, R.R.
AU - de Bruin, D.M.
AU - Savci-Heijink, C.D.
AU - Postema, A.W.
AU - Wagstaff, P.G.K.
AU - Muller, B.G.
AU - Varkarakis, I.M.
AU - Skolarikos, A.
AU - Zondervan, P.J.
AU - Laguna Pes, M.P.
AU - de Reijke, T.M.
AU - de la Rosette, J.J.M.C.H.
JO - Asian Journal of Urology
PY - 2016
VL - 196
TODO - 2
SP - 552-559
PB - HANLEY & BELFUS-ELSEVIER INC
SN - 2214-3882
TODO - 10.1016/j.juro.2016.02.2977
TODO - adult;  aged;  Article;  clinical article;  cystic fibrosis;  electroporation;  histopathology;  human;  human tissue;  irreversible electroporation;  male;  microscopy;  pancreas necrosis;  priority journal;  prostate cancer;  tumor ablation;  urethra;  urothelium;  ablation therapy;  clinical trial;  electroporation;  follow up;  middle aged;  pathology;  phase 1 clinical trial;  phase 2 clinical trial;  procedures;  prostate tumor;  prostatectomy;  treatment outcome, Ablation Techniques;  Adult;  Aged;  Electroporation;  Follow-Up Studies;  Humans;  Male;  Middle Aged;  Prostatectomy;  Prostatic Neoplasms;  Treatment Outcome
TODO - Purpose Irreversible electroporation is a tissue ablation modality that uses high voltage electric energy to induce an increase in cell membrane permeability. This causes destabilization of the existing cellular transmembrane potential leading to cell death, due to the inability to maintain cellular homeostasis. This phase I-II study was designed to evaluate the histopathological outcomes of irreversible electroporation to prostate and surrounding tissue in radical prostatectomy specimens. Materials and Methods Sixteen patients with prostate cancer underwent an irreversible electroporation ablation without curative intent, followed by radical prostatectomy scheduled 4 weeks later. For histopathological examination of the prostate, whole mounted tissue slices were examined by dedicated genitourinary pathologists. The borders of the ablation zone and residual tumor were outlined on the slides. Results The irreversible electroporation ablation zones were characterized as areas of fibrosis, necrosis and loss of epithelial tissue in terms of denudation in the glandular structures. The ablation zone was well demarcated, showing trenchant delineations between viable and nonviable tissue. The ablated tissue showed mild to moderate inflammation, with atrophic cells in 1 case. The area was surrounded by hemorrhage at the location of the electrodes. No skip lesions or viable tissue was seen in the ablation zone. Fibrinoid necrosis of the neurovascular bundle was observed in 13 patients and denudation of the urothelium of the prostatic urethra was seen in 9. Conclusions Histopathological assessment of the prostate 4 weeks after irreversible electroporation ablation showed sharply demarcated fibrotic and necrotic tissue in the ablation zone. No viable tissue was observed in the irreversible electroporation ablation zone. © 2016 American Urological Association Education and Research, Inc.
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